A diagonal earlobe crease called Frank’s sign may signal hidden heart disease risk, especially alongside diabetes, hypertension, smoking, or obesity.
When people think about warning signs of heart disease, symptoms like chest pain, breathlessness, fatigue, or irregular heartbeat usually come to mind. But doctors say there may be another subtle clue hiding in plain sight – right on your ears.
A small wrinkle or diagonal crease on the earlobe, known as Frank’s sign, has increasingly been linked to cardiovascular disease in several medical studies. While it may look harmless, experts believe this tiny mark could signal underlying problems with blood vessels and heart health.
What is Frank’s sign?
Frank’s sign refers to a diagonal crease or fold that stretches across the earlobe, typically at a 45-degree angle. The condition was first identified by physician Dr. Sanders T. Frank, who noticed that many patients under the age of 60 with chest pain and blocked coronary arteries also had this visible crease.
Since then, multiple studies have explored the relationship between earlobe creases and heart disease risk. Researchers have found connections between Frank’s sign and conditions such as:
- Coronary artery disease (CAD)
- Peripheral vascular disease
- Stroke and mini strokes
- Atherosclerosis
- High blood pressure complications
Some studies even suggest that people with deep, bilateral creases – meaning they appear on both ears- may face a higher risk of heart-related complications.
Why could an earlobe crease signal heart trouble?
Scientists are still investigating the exact reason behind the connection. One theory is that the crease develops due to a loss of elastin and elastic fibres in the body. These same changes can also damage blood vessels and arteries, contributing to coronary artery disease.
Another theory suggests that genetics may play a role. Researchers have observed the association between ear creases and heart disease across different ethnic groups, indicating there could be an inherited component. A few studies have also linked Frank’s sign to lower levels of proteins called adropin and irisin, which help regulate blood vessel function and metabolism. Low levels of these proteins may contribute to plaque buildup inside arteries, increasing the risk of heart attack and stroke.
Does everyone with Frank’s sign have heart disease?
Not necessarily. Doctors stress that an earlobe crease alone should not be considered proof of cardiovascular disease. Many people with the crease may never develop heart problems, while others without it may still be at risk. However, the sign may become more meaningful when combined with traditional heart disease risk factors such as:
- Smoking
- High cholesterol
- Diabetes
- Obesity
- High blood pressure
- Sedentary lifestyle
- Family history of heart disease
Medical experts say the severity of the crease may also matter. A complete, deep crease on both earlobes is believed to carry a stronger association with cardiovascular disease than a faint or incomplete wrinkle on one ear.
When should you see a doctor?
If you notice a diagonal crease in your earlobe and also have other heart disease risk factors, it may be worth discussing with a healthcare professional. Doctors can assess your cardiovascular health through blood pressure checks, cholesterol testing, heart scans, and lifestyle evaluations.